Inpatient rehab facilities will get a 2.9% pay increase in CMS proposed rule

Inpatient rehabilitation services are obtaining a payment boost of 2.nine% for 2021. Mainly because of

Inpatient rehabilitation services are obtaining a payment boost of 2.nine% for 2021.

Mainly because of the COVID-19 general public health and fitness crisis, the Centers for Medicare and Medicaid Services in its proposed rule has constrained the yearly rulemaking to payment and critical procedures.

CMS is proposing updates to the payment fees making use of the most current knowledge to replicate an believed 2.5% boost element. This is the inpatient rehabilitation facility market place basket boost element of 2.nine%, minimized by a .four% multifactor efficiency adjustment.

Nevertheless, an supplemental .four% boost to aggregate payments — because of to updating the outlier threshold to sustain believed outlier payments at three% of whole payments — benefits in an total update of 2.nine%, or $270 million. 

CMS is also proposing to undertake the most current Office environment of Administration and Funds statistical spot delineations and implement a 5% cap on wage index decreases from 2020 to 2021.

In one more go to relieve medical doctor stress, CMS is proposing to allow for non-medical doctor practitioners to conduct any of the inpatient rehabilitation facility protection company and documentation obligations that are presently necessary to be carried out by a rehabilitation medical doctor.

IRFs are typically necessary to carry out a post-admission medical doctor analysis in just the very first 24 several hours of the patient’s admission to confirm that no variations have happened considering that the preadmission screening, and that the patient is nevertheless correct for admission to an inpatient rehabilitation facility.

CMS is proposing to no longer demand a post-admission medical doctor analysis considering that the post-admission analysis handles substantially of the very same information and facts and proceeds to be incorporated in the pre-admission screening of the patient and the patient’s prepare of care.  

IRFs, in session with the patient’s medical doctor or other treating clinician, would nevertheless have the overall flexibility to carry out patient visits in just the very first 24 several hours of an admission if the patient’s ailment warrants it.

CMS is proposing no variations to the inpatient rehabilitation facility high-quality reporting system.


Owing to the COVID-19 general public health and fitness crisis, healthcare vendors have constrained capacity to evaluation and provide opinions on in depth proposals, CMS said.

CMS is also soliciting opinions from stakeholders on more concepts to decrease service provider stress, as very well as on proposals to codify subregulatory guidance on preadmission screening documentation and specified other IRF protection prerequisites.

CMS will acknowledge opinions until June 15.

THE Larger Trend

CMS has a short while ago issued an array of short term regulatory waivers and new rules to give vendors highest overall flexibility to answer to the COVID-19 pandemic.

This contains waiving the sixty% rule that demands each and every IRF to discharge at least sixty% of its people with a person of 13 qualifying situations.

New overall flexibility also allows the necessary confront-to-confront medical doctor visits in IRFs to be finished making use of telehealth.

The IRH proposed rule is a person of 5 proposed Medicare payment rules produced in a fiscal yr cycle to define payment and plan for inpatient hospitals, extended-time period care hospitals, inpatient rehabilitation services, inpatient psychiatric services, skilled nursing services and hospices.

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